St James's Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive- this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people’s needs were not always met.

The provider and registered manager were in breach of the legal regulation relating to dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices.

People’s care was not consistently personalised, and involvement in planning was limited. People told us they were not involved in their care planning. Most relatives told us they were not involved in people’s care plans. However, one relative told us “I wasn’t involved in the care plan review originally, but I complained and I have been involved since then”.

Some staff told us, due to staffing constraints, they did not feel they were always able to provide person-centred care.

We observed some people’s rooms were personalised. For example, one person had a memory board showing the date, any expected visitors and the weather for the day. A relative told us, “The handy man is always happy to help, hanging photos on the wall and making her room homely”.

There were some shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined-up, flexible or supportive of choice.

Continuity of care was inconsistent, and gaps in records impacted safe delivery.

Daily activity records showed people were not always being supported in line with their assessed needs.

The registered manager told us about the challenges they had faced since COVID-19. For example, when a person was admitted to the service there had been delays in receiving appropriate medicines and medical visits. The registered manager told us they consistently had to chase professionals to help ensure they were able to provide joined-up care.

The provider could supply information in formats tailored to individuals needs. However, people were not involved in their care plans and did not have information provided about their care and treatment.

The complaints procedure and accessible information standard information was displayed on the wall around the service. Since 2016, all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says people should get the support they need in relation to communication.

A relative told us, “Communication is pretty good”.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, feedback was not always acted on.

Feedback had been collected through a residents meeting, however this had not been actioned or analysed.

We received mixed feedback from relatives around raising concerns and appropriate action being taken.

We saw records of feedback from relatives and professionals being provided via a digital platform.

The provider did not always make sure some people’s needs were met.

We saw records of involvement from GP’s, chiropodist, occupation therapists and dentists. However, we received mixed feedback from relatives in relation to the service acting promptly in escalating concerns. Comments included, “I called the GP myself, paramedic was sent, and medication was reduced. They don’t see the signs of health deterioration,” and another told us “They get the GP when needed, dentist also”.

The provider had an Equality, Diversity and Human rights policy and the training matrix showed most staff had completed equality and diversity training.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We received mixed feedback from people about activities and their wellbeing needs being met. Comments included, “There isn’t really any activities to do. I have asked for things before like having my nails painted, but I get told it’s not an activity or there isn’t enough staff. They do bingo sometimes and I have been on occasions”. Another said, “I always have enough activities to do. I like music the most and I will try chair golf sometimes depending how I feel. I like colouring”.

We received mixed feedback from relatives in relation to activities, comments included, “They do bingo here. Most of the activities here are for women,” and “(Person’s name) is offered many different activities, like bingo and seated golf. The staff help put on their favourite music channels and sing along”.

We observed relatives visiting people with no restrictions applied to when they were able to visit.

One person told us about religious needs being met through services that took place in the communal lounge.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

End-of-life planning was insufficient. One person moved into the service to receive end of life care. This person’s care records did not include details about what was important to them at that stage of life, such as specific wishes relating to funeral arrangements, or information on who they wanted to be present and what mattered to them at this stage of their life.

This contributed to the breach of regulation in relation to dignity and respect.

One relative told us, “(Person’s name) is receiving palliative care, I had lots of questions which have all been answered with care and kindness”.

The training matrix showed some staff had completed End of Life care training.